Angry Doctor

Wednesday, July 05, 2006

Interpreter of Maladies 2

"Trying to communicate through an untrained interpreter is like playing the children’s game of telephone: Start with a sentence, pass it along a chain of people, and laugh when it emerges altered and garbled at the end of the chain. Except in a clinic situation with an untrained interpreter, you are left wondering whether what you asked was what the patient heard. And that’s not funny.

Study after study has shown that untrained interpreters in medical settings—such as husbands, friends, secretaries, and janitors who have some bilingual skills and happen to be available—are reliably unreliable. They typically lack fluency in English, the linguistic skills to convert from one language into the other, and knowledge of the medical terminology that’s needed to provide an accurate and complete interpretation. They might have their own agendas or opinions and, in the worst cases, might intentionally cover up their own abuse of the patient."

- from Doctoring Across The Language Divide, Health Affairs


  • Don't talk about interpreters who don't know medical terms etc....

    Even doctors have a problem communicating with non-english or even english speakers in Singapore.

    Locally, many patients do not have vocabularies in either English or Mandarin to make a smooth conversation and translation.

    You talk about medical terms even in layman explanation and they still don't understand it.

    As for Mandarin, if you speak in the proper Mandarin translation of certain English medial terms, the Mandarin speakers don't understand either! They don't even know the Chinese words!

    We haven't even talked about translating to the dialects, Cantonese, Hokkien, Teochew? And what about Malay? Tamil?!!!!

    In fact the older folks would rather be told that they are "too heaty" than be told they have the common cold. Use all kinds of non-medical, incorrect lingo to explain their problems to them.

    A Voltaren injection is called a "Hong jum" (wind needle) to them!

    I think Singapore has a big problem with interpretation especially for the older folks, of which the majority are uneducated. I call them the aging uneducated and one has to take a different approach to seeing them and communicating with them.

    As for the migrant population coming to the Bangladeshis, Thais, Myanmar nationals.....I don't see them very much. Anyone can share their experiences?

    I think we can safely conclude that it is unlikely that we will see full time interpreters ( can translate fluent hokkien, cantonese, teochew, thai, malay etc) at the polyclinics or hospitals anytime soon.

    By Blogger Dr Oz bloke, At July 06, 2006 10:50 am  

  • I agree because doctors assume they can speak proper Mandarin when talking to Chinese patients. (But I assure that they don't know that their standard is ....)

    Luckily I have a background in biology so I can briefing explain to my folks when I bring them to see doctors.

    By Anonymous Anonymous, At July 06, 2006 12:46 pm  

  • It's not just the doctor's proficiency in mandarin.

    My mandarin is not fantastic but I can communicate. But when trying to communicate certain terms like 甘油三酸酯, 胰岛素, 新陈代谢, etc...many patients dunno what that is either.

    So it's not just the language issue. It's how you can explain concepts and medical terms into simple layman explanatory words in the language of the patient.

    Now one can imagine that the communication process would take maybe twice or 3 times as long as normal. Hence the time needed to see a patient is longer.

    Of course the other reality is that most of such patients can't be bothered to listen to explanations anyway. They prefer to see the doctor, doctor give me medicine and bye bye.

    By Blogger Dr Oz bloke, At July 06, 2006 1:00 pm  

  • Just last week, saw a lady doctor at a polyclinic and she told me that I had urine infection.

    I have heard of urinary tract infection and other terms of common infection in females.

    Honestly, never heard of urine infection, I was a bit confused and ask if she meant UTI.

    She is around my age and I am sure she can communicate better than that instead of looking down on a patients thinking we are uneducated just because we are not medical students.

    By Anonymous Anonymous, At July 06, 2006 4:10 pm  

  • i do not think the lady dr was looking down on u per se.

    most people wouldn't know what UTI stands for, but they would understand urine infection.

    if the dr just said "UTI" like that, other people might complain that she didn't explain it to them or imagined they knew everything.

    either way, it's not so difficult to find fault with drs.

    By Anonymous Anonymous, At July 07, 2006 12:03 am  

  • Dear Anon who had urinary tract infection,

    It's good that you are familiar with these terms. That's very good. But try to understand that the reality out there is that for every one of you, there are 10 others who have no idea what Urinary Tract is. Especially when said in Mandarin.

    I have personally seen executives who when told they have urinary tract infection go "Huh?"

    And then you tell them "Urine infected" and they go "Ohh! Then say lah!"

    So anon, remember that you live in Singapore where the majority of people speak Singlish, have a poor english and mandarin vocabulary, and are very uninformed in science and current affairs.

    You are the minority. Doctors have to generally cater to the majority FIRST and then tweak the way they treat you the minority.

    We plead for some understanding.

    By Blogger Dr Oz bloke, At July 07, 2006 10:35 am  

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